Organization
EVERGREEN MEDICAL CENTER LLC
Active
Other names
EVERGREEN PRIMARY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES POWELL (OFFICE MANAGER)
(251) 578-0278
Entity
Organization
Contact information
Practice address
100 EDWINA STREET, EVERGREEN, AL 36401-3319
(251) 578-0278
(251) 578-0290
Mailing address
100 EDWINA STREET, EVERGREEN, AL 36401-3319
(251) 578-0278
(251) 578-0290
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
11/06/2012
Last updated
11/06/2012
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